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Influential factors and clinical significance of fluid-attenuated inversion recovery vascular hyperintensities in transient ischemic attacks of carotid arterial system

  • Diagnostic Neuroradiology
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Abstract

Purpose

Fluid-attenuated inversion recovery vascular hyperintensity (FVH) is often observed in conjunction with acute ischemic stroke (AIS) of the carotid system. Despite its bearing on patient care outcomes, factors influencing FVH and its clinical significance in patients with transient ischemic attacks (TIAs) of the carotid arterial system have yet to be evaluated.

Methods

Consecutive inpatients (N = 154) diagnosed with TIAs of the carotid system in a 2-year period (2012–2014) were enrolled in our study. Each had undergone magnetic resonance imaging (MRI) within 72 h of symptom onset, followed by intracranial and extracranial vascular imaging. We investigated the frequency and nature of factors associated with FVH, also examining its clinical significance in the 30-day prognosis of TIA.

Results

Of the 154 patients enrolled (male, 92; mean age 63.0 ± 11.9), FVH was confirmed in 61 patients (39.6%). In logistic regression analysis, intracranial large-artery disease (LAD) (OR = 2.39, 95% CI 1.16–4.92; p = 0.018) and prior stroke (OR = 3.33, 95% CI 1.48–7.51; p = 0.004) emerged as factors independently associated with FVH positivity. Ultimately, 25 patients (16.2%) progressed to AIS within a 30-day follow-up period. Logistic regression analysis indicated that contralateral FVH positivity (OR = 5.98, 95% CI 1.81–19.76; p = 0.003), atrial fibrillation (OR = 7.05, 95% CI 1.33–37.40; p = 0.022), and extracranial LAD (OR = 4.12, 95% CI 1.26–13.41; p = 0.019) were independently associated with AIS during the 30-day follow-up of TIAs in these patients.

Conclusion

Intracranial LAD and previous stroke are independently associated with FVH in patients experiencing carotid system TIAs. If present, FVH may predict an oncoming AIS in the 30 days following a TIA.

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Authors and Affiliations

  1. Department of Neurology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, 110004, Shenyang, Liaoning, People’s Republic of China

    Xiaoyu Dong, Chaobo Bai & Jianfei Nao

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  1. Xiaoyu Dong
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  2. Chaobo Bai
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Correspondence to Jianfei Nao.

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The authors declare that they have no conflict of interest.

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All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Dong, X., Bai, C. & Nao, J. Influential factors and clinical significance of fluid-attenuated inversion recovery vascular hyperintensities in transient ischemic attacks of carotid arterial system. Neuroradiology 59, 1093–1099 (2017). https://doi.org/10.1007/s00234-017-1906-z

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  • DOI: https://doi.org/10.1007/s00234-017-1906-z

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